Provider Demographics
NPI:1144204454
Name:ALLIANCE PHYSICAL THERAPY CONSULTANTS PA
Entity Type:Organization
Organization Name:ALLIANCE PHYSICAL THERAPY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:ASH
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:603-332-1881
Mailing Address - Street 1:249 ROCHESTER HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1775
Mailing Address - Country:US
Mailing Address - Phone:603-332-1881
Mailing Address - Fax:603-332-6882
Practice Address - Street 1:249 ROCHESTER HILL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1775
Practice Address - Country:US
Practice Address - Phone:603-332-1881
Practice Address - Fax:603-332-6882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0401225100000X
MEPT446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0805836YONH01OtherANTHEM BCBS
NH30002637Medicaid
NH3946OtherHEALTHSOURCE
NH2079018OtherCIGNA